504 



SCIENCE 



[N. S. Vol. XLVI. No. 1195 



capillary pressure; and, finally, preserva- 

 tion of the balance between the osmotic 

 pressure of the fluid inside the blood-ves- 

 sels and outside in the tissues. It was 

 shown that considerable success had been 

 reached in this problem by the experiments 

 of Professor Bayliss and others. 



A final point dealt with was the treat- 

 ment of tetanus by administration of ' ' anti- 

 tetanus serum." This serum is obtained 

 from the blood of horses which have been 

 subjected to gradually-increasing doses of 

 tetanus-toxin, the poison produced by the 

 tetanus-bacillus. The high efficiency of 

 this anti-toxic serum when used as a pro- 

 phylactic was first demonstrated on man on 

 a large scale by its employment in the first 

 autumn of this war. Curves illustrating 

 the statistics were shown. The severe out- 

 break of tetanus which ensued in the 

 troops at the outset of the campaign was 

 checked and practically stopped almost in- 

 stantaneously by the orders that every 

 wounded man, as soon as possible after be- 

 ing wounded, that is to say, at the first field 

 casualty-station, should receive a small in- 

 jection of anti-tetanus serum from the im- 

 munized horse. But the efficacy of the 

 serum when once signs of tetanus have ap- 

 peared in the patient is far less satisfac- 

 tory. The remainder of the lecture was de- 

 voted to discussion of why this should be, 

 and in what ways the difficulty may be, at 

 least in part, overcome. 



Charles S. Sherrington 



PRE-MEDICAL TRAINING IN 

 CHEMISTRYi 



As a country we are rubbing the sleep out of 

 our eyes and wishing we had split the kindling 

 and brought up the coal the night before. The 

 alarm clock has been ringing for some time, 



1 Read before the Division of Biological Cliem- 

 istry, American Chemical Society, Boston, Sep- 

 tember, 1917. 



but we have preferred our dreams of ease to the 

 realities of necessities. 



The medical profession is awake and trying 

 to start the water boiling, but finds it can not 

 lay the fire. The wood and coal are at hand, 

 but the knowledge of their proper use is lack- 

 ing. Now, more than ever, do progressive 

 physicians realize the dependency of successful 

 practise on a well-founded knowledge of the 

 chemistry of the human body, and more than 

 ever do they irritably contemplate their lack 

 of preparation. 



This lack of preparation in a science so ob- 

 viously fundamental to rational understanding 

 of the human mechanism as to require no elab- 

 oration, at present exists; that a continuation 

 of this condition should be allowed is a parody 

 upon our intelligence. 



The futility of expecting the physician to 

 utilize all possible sources of relief to suffering 

 without a knowledge of the application of basic 

 chemical principles to the body reactions is 

 apparent. 



It is equally as absurd to expect the medical 

 student to appreciate or assimilate the possi- 

 bility of chemistry being a practical science 

 for his uses, if he does not have sufficient 

 foundation in this subject before he enters the 

 medical school. The medical school is funda- 

 mentally a school of applied science. It is 

 where the individual is taught science as ap- 

 plied to the human body. Any attempt to 

 teach a student biological chemistry without 

 his having received an adequate foundation in 

 the fundamental principles of chemistry in 

 general, and to expect him to know much 

 of anything when we are through with him, is 

 as idiotic as to try to teach calculus to men 

 who have yet to know algebra. The foundation 

 must be laid in the pre-medical work. 



It is only in recent years that the teaching 

 of elementary chemistry has been dropped 

 from the medical curriculum. Unfortunately 

 however even to-day it is only the few schools 

 interested in turning out doctors instead of 

 groups of men competent to pass State-board 

 examinations, that have adapted themselves to 

 the logical demand of the times as justified by 

 the ever-increasing applicability of chemical 



